https://orcid.org/0000-0002-5747-2151
-
Views
-
Cite
Cite
Shruti Gupta, Ilya G Glezerman, Jamie S Hirsch, Sophia L Wells, Kevin L Chen, Robert H Seitter, Audrey E Monson, Olivia Green-Lingren, Kenar D Jhaveri, Valda D Page, Matthew H Abramson, Anip Bansal, Ala Abudayyeh, David E Leaf, Effect of mannitol on cisplatin-associated acute kidney injury: a target trial emulation, Nephrology Dialysis Transplantation, Volume 40, Issue 2, February 2025, Pages 405–408, https://doi.org/10.1093/ndt/gfae233
Close - Share Icon Share
Extract
To the Editor,
Acute kidney injury (AKI) one of the most common toxicities caused by cisplatin, and no therapy reliably prevents it [1, 2]. Animal models of cisplatin-associated AKI (CP-AKI) suggest that mannitol, an osmotic diuretic, attenuates nephrotoxicity by reducing the urinary concentration of cisplatin and acting as a free radical scavenger [3]. However, its use is controversial, as mannitol has also been associated with proximal tubular cell swelling and vacuolization, and could therefore increase the risk of AKI [4]. As a result, there is considerable interhospital variation in the use of mannitol for CP-AKI prevention. We used data from a large multicenter cohort study of patients treated with cisplatin to estimate the effect of treatment with mannitol on CP-AKI incidence.
We emulated a hypothetical target trial in which patients receiving cisplatin did or did not receive IV mannitol on the day of cisplatin administration (Supplementary data, Table S1, Supplemental Methods). We used data from a multicenter cohort study of >24 000 adults treated with their first dose of intravenous (IV) cisplatin between 2006 and 2022 at six major cancer centers across the USA, as previously reported (Supplementary data, Table S2, Supplemental Methods) [5]. This study was approved by the institutional review board (IRB) at each participating site, and by the Mass General Brigham IRB for the overall study.
Comments